Provider Demographics
NPI:1861122665
Name:LUTTSCHWAGER, ERIN (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LUTTSCHWAGER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 CHAPEL VIEW RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-7653
Mailing Address - Country:US
Mailing Address - Phone:920-217-8558
Mailing Address - Fax:
Practice Address - Street 1:3340 LINEVILLE RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-7237
Practice Address - Country:US
Practice Address - Phone:920-217-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional